Provider Demographics
NPI:1073133369
Name:DIGNITAS CARE
Entity Type:Organization
Organization Name:DIGNITAS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMONISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-853-5260
Mailing Address - Street 1:4600 CYPRESS KNEE DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2116
Mailing Address - Country:US
Mailing Address - Phone:561-853-5260
Mailing Address - Fax:
Practice Address - Street 1:4600 CYPRESS KNEE DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2116
Practice Address - Country:US
Practice Address - Phone:561-853-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home